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Dear patient, the whole problem is the ten minute consultation

Dear patient,

I know you hate it when I tell you that we only have ten minutes and I can’t therefore deal with multiple problems. Or that because you are eight minutes late that unless its something quite straightforward you will have to rebook, but there are reasons.

In that ten minutes, just think what has to happen

The entire problem is the ten-minute consultation.

Firstly, it isn’t just your ten minutes that I have, it’s the ten minutes for the patients crammed either side of you. In fact, in the three hours that I see patients, there are 18 patients with ten minutes each, them with me and me with them. That’s right, three hours, 18 patients back to back and no break.

In that ten minutes, just think what has to happen. Firstly you have to get to me from the waiting room, for some this takes two or three minutes. For the old, disabled, mums with  kids, people in pain, it takes time. So now I have eight short minutes to listen to you, ask questions, look at previous notes and start formulating a plan.  I may have to do an examination, get you up on the couch, get a urine sample, test it and then decide what to do. You could need a prescription, some instructions and what to look out for. It may also involve one or even two referrals. That means a typed letter and possibly a booking through an electronic system. Oh and then I have to write your notes, and those should be as detailed and accurate as possible because I know it helps the next doctor you see and saves you the frustration of repetition. Imagine doing all of this properly and thoroughly in ten minutes? Then imagine the same process for each of the ‘just a few things’ that you would like to discuss with me today. Then imagine doing it 18 times on the trot.

While all of this is going on there are telephone calls, results from the day before to check and action, documents coming in constantly from hospitals and other professionals that need action. Sometimes I even have to go to the toilet.

A friend of mine who is not a doctor seemed to feel that I was over-egging it and the only comparison I could draw that seemed to resonate was this: imagine you were at a job interview putting your best you forward and having to be at the top of your game. Then imagine a bell ringing at ten minutes and the interviewer walking out and a brand new one arriving and you had to start all over again, 18 times.  Would you be as fresh at the 18th as you were at the first? What if you had to type up some notes at the end of each interview and maybe a letter or two? Could you, and run on time? And if you choose to run late, are you happy for that to encroach into your personal time, to not get home in time to see your kids or go to the gym?

So what is my message? Well firstly, it’s not deliberate. The pressure from the Government to deliver endlessly more appointments have led to the introduction of the ten minute consultation. Secondly, whichever kind of GP yours is, whether they run late or on time, please understand that they are trying to do their best by you. They have either chosen to do that by dealing with everything and running late or keeping to time and limiting problems. They are also human and need to drink, pee and have time with their families and to relax. And if you feel really strongly about it, write to your MP, please.

Yours faithfully,

Your tired GP

Dr Renee Hoenderkamp is a first-year qualified GP in north London. You can follow her on Twitter @DrHoenderkamp

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